A comprehensive evaluation of fasting serum gastrin-17 as a predictor of diseased stomach in Chinese population. (October 2014)

• Record Type: Journal Article
• Authors: Sun, Liping; Tu, Huakang; Liu, Jingwei; Gong, Yuehua; Xu, Qian; Jing, Jingjing; Dong, Nannan; Yuan, Yuan
• Is Part Of: Scandinavian journal of gastroenterology. Volume 49:Number 10(2014)
• Page Start: 1164
• Page End: 1172
• Publication Date: 2014-10
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2014.950693
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Background and aim.</italic> </bold> Fasting serum gastrin-17 (FsG17) is considered as a noninvasive biomarker reflecting the structure and functional status of gastric mucosa, but its clinical utility remains unclear. This study aimed to evaluate FsG17 comprehensively: establish the ranges and cut-off points of FsG17 levels in different gastric diseases, identify their influencing factors, and investigate the accuracy of FsG17 for identifying diseased stomach. <bold><italic>Methods.</italic></bold> The study included 4064 participants from Northern China between 2008 and 2013. FsG17 and serum <italic>Helicobacter pylori</italic> IgG antibody levels were measured by enzyme-linked immunosorbent assay. Diagnostic accuracy was assessed by receiver operator characteristic curves. Multivariate logistic regression analysis was performed to determine the best predictors of gastric histopathological conditions. <bold><italic>Results.</italic></bold> Median FsG17 levels in healthy, non-atrophic, atrophic, and cancerous stomachs were 1.8, 4.0, 3.8, and 6.1 pmol/l, respectively. Age, smoking status, alcohol consumption, <italic>H. pylori</italic> infection, and predominant lesion site were factors that affected FsG17 levels. The optimal cut-off values for FsG17 were 3.0 pmol/l (sensitivity of 59.3% and specificity of 67.3%) for discriminating between healthy stomach and diseased stomach and 10.7 pmol/l (sensitivity of 37% and specificity of 83.7%) for discriminating between cancerous stomach and cancer-free stomach; the screening accuracy was higher (sensitivity of 50.0% and specificity of 83.0%) for gastric cancer in the corpus. Multivariate analysis showed that FsG17, gender, age, and <italic>H. pylori</italic> infection were independent predictors of cancerous stomach. <bold><italic>Conclusion.</italic></bold> With the progression from health stomach to malignancy, FsG17 levels significantly increased and were influenced by other factors. FsG17 combined with age, gender, and <italic>H. pylori</italic> infection could distinguish between cancerous stomach and cancer-free stomach. The results will enhance our understanding of the potential clinical utility of FsG17.</p> </abstract>